Provider Demographics
NPI:1689291205
Name:DAVIS, TAYLOR (DC)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 FRISCO SQUARE BLVD APT 159
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3495
Mailing Address - Country:US
Mailing Address - Phone:214-636-7775
Mailing Address - Fax:
Practice Address - Street 1:1880 N STONEBRIDGE DR
Practice Address - Street 2:STE 240
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7562
Practice Address - Country:US
Practice Address - Phone:214-636-7775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14423111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty